HomeMy WebLinkAbout0049 JONES ROAD - Health '49 Janes Road �x
Marstons Mills_
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CERTIFICATE OF ANALYSIS L
Barnstable County Health Laboratory AUG 15 Report Prepared For: Report Dated: 08/05/2002 TOWNOFDeWolfe Direct Order Number:
Jennifer Palmer
1070 Iyannough Rd.
Hyannis, MA 02601
Laboratory ID#: 0216410-01 Description: Water-Drinking Water
Sample#: 16410 Sampling Location: 49 Jones Rd.,Marstons Mills Collected: 07/31/2002
ollected by: Jennifer Palm 0 g te 0 3 D Received: 07/31/2002
Routine
ITEM RESULT UNITS MDL MCL Method# Tested
LAB:IC Lab
Nitrates 2.0 mg/L 0.1 10 EPA 300.0 08/01/2002
LAB: Metals
Copper 0.1 mg/L 0.1 1.3 SM 3111 B 08/02/2002
Iron 0.1 mg/L 0.1 0.3 SM 311113 08/02/2002
Sodium 11 mg/L 1.0 20 SM 311113 08/02/2002
LAB:Microbiology
Total Coliform Absent P/A 0� Absent P/A 07/31/2002
LAB: Physical Chemistry
Conductance 118 umohs/cm 1 EPA 120.1 08/01/2002
pH 6.4 pH-units 0 EPA 150.1 08/01/2002
Note: Water sample meets the recommended limits for drinking water of all above tested parameters.
Approved By:
(Lab Director)
Jl/9�zao 2-
r ..
i
Superior Court House, PO.Bog 427, Barnstable, MA 02630 Ph: 508-375-6605
P
TROY WILLIAMS
SEPTIC INSPECTIONS Y36
Certified by MA Department of Environmental Protection LRIECM -1 D
19 Hummel Drive
South Dennis, MA 02660 ; 1 s 7002COMMONWEALTH OF MASSACHUSE17S of 6Ar�rvsTAafEEXECUTIVE OFF1C E OF ENVIRONMENTALi-TH DEPT.
DEPARTMENT OF ENVIRONMENTAL PROTECTION
TITLE 5
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM
PART A
CERTIFICATION
Propert% Address: 49 Jones Road
Marstons Mills,MA n
Owner's Name: Jeanie Rooney
Owner's Addres,: 49 Jones Road
Marstons Mills,MA 02648 O,
Date of Inspection: August 7,2002
Name of Inspector: Troy M. Williams
Company Name: Troy Williams Septic Inspections
Mailing Address: 19 Hummel Drive
South Dennis, MA 02660
Telephone Number: (508)385-1300
CERTIFICATION STATEMENT
1 certify that I have personally inspected the sewage disposal system at this address and that the information reported
below is true,accurate and complete as of the time of the inspection. The inspection was performed based on my
training and experience in the proper function and maintenance of on site sewage disposal systems. 1 am a.DEP
appros ed system inspector pursuant to Section 15.340 of Title 5(310 CMR 15.000). The system
✓ Passes
Conditionall\- ('asses
Needs Further Evaluation b) the Local Approving Authoni�
Fails
Inspector's Signature: �,��, l��.c.��c�,� Date: 8 17/a A
The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of I lealth or
DEP)within 30 days of completing this inspection. If the system is a shared system or has a design flow of 10,000
gpd or greater, the inspector and the system owner shall submit the report to the appropriate regional office of the
DEP. The original should be sent to the system owner and copies sent to the buyer, if applicable,and the approving
authority.
Notes and Comments
Although system meets the minimum requirements set forth by the Massachusetts Department of
Environmental Protection,certification is not to be construed as a guarantee of future working condition
Of system,p)ping or components. This inspection represents the conditions of the system on the Date of
Inspection noted above.
•***This report only describes conditions at the time of inspection and under the conditions of use at that
time. l his inspection does not address how the system will perform in the future under the same or different
conditions of use.
Title 5 Inspection Form 6/15/2000 naee I
t Page 2 of I I
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION (continued)
Property Address: 49 Jones Road
Owner: Marstons Mills,MA
Date of Inspection: Jeanie Rooney
August 7,2002
Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D
A. System Passes:
I have not found any information which indicates that any of the failure criteria described in 310 CNIR
15.303 or in 310 CMR 15.304 exist. Any failure criteria not evaluated are indicated below.
Comments:
B. System Conditionally Passes:
One or more system components as described in the"Conditional Pass"section need to b eplaced or
repaired. The system, upon completion of the replacement or repair,as approved by the Board f Health,will pass.
Answer yes. no or not determined(Y,N,ND)in the_ for the following statement . f"not determined"please
explain.
The septic tank is metal and over 20 years old* or the septic tank( ether metal or not)is structurally
unsound,exhibits substantial infiltration or exfiltration or tank failure i ' minent. System will pass inspection if the
existing tank is replaced with a complying septic tank as approved b he Board of Health.
*A metal septic tank will pass inspection if it is structurally soun ,not leaking and if a Certificate of Compliance
indicating that the tank is less than 20 years old is available.
ND explain:
Observation of sewage backup or break t or high static water level in the distribution box due to broken or
obstructed pipe(s)or due to a broken,settle r uneven distribution box. System will pass inspection if(with
approval of Board of Health):
ken pipe(s)are replaced
obstruction is removed
distribution box is leveled or replaced
ND explain:
The syst required pumping more than 4 times a year due to broken or obstructed pipe(s). The system will
pass inspect' if(with approval of the Board of Health):
broken pipe(s)are replaced
obstruction is removed
ND explain:
2
Page 3 of 1 I
OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM '
PART A ..
CERTIFICATION(continued)
Property Address:
49 Jones Road
Owner: Marstons Mills,MA
Date of frtspection: Jeanie Rooney
August 7,2002
C. Further Evaluation is Required by the Board of Health:
Conditions exist which require further evaluation by the Board of Health in order to determine if the system
is failing to protect public health. safety or the environment.
1. S)'stem will pass unless Board of Health determines in accordance with 310 CMR 15.3 1)(b)that the
system is not functioning in a manner which will protect public health,safety and t environment:
_ Cesspool or privy is within 50 feet of a surface water
_ Cesspool or privy is within 50 feet of a bordering vegetated wetland or a s t marsh
2. System will fail unless the Board of Health(and Public ater Supplier, if anyydetermines that the
system is functioning in a manner that protects the publi ealth,safety and environment:
_ The system has a septic tank and soil absorp ' n system(SAS)and the SAS is within 100 feet of a
surface water supply or tributary to a surface ter supply.
_ The system has a septic tank and S and the SAS is within a Zone I of a public water supply.
_ The system has a septic tan•and SAS and the SAS is within 50 feet of a private water supply well.
_ The system has a se 'c tank and SAS and the SAS is less than 100 feet but 50 feet or more from a
private water supply w •". Method used to determine distance
"This system sses if the well water analysis, performed at a DEP certified laboratory, for coliform
bacteria an olatile organic compounds indicates that the well is free from pollution from that facility and
the pre ce of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other
fail criteria are triggered.A copy of the analysis must be attached to this form.
3. Other:
����: Wf.II wG) �"bVnat O✓ar �oQ -'4�0..... ��S ��10 Ft S 1.✓^) ti l-� ��ct�
I DV fY•.., It r.. �. r,✓. A(SF'U �t c a �sr In c.r.( �n.� <r ti.. I � ) ) 77,0-., ��IO°•
3
Page 4 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART A
CERTIFICATION(continued)
Property Address: 49 Jones Road
Marstons Mills,MA
Owner: Jeanie Rooney
Date of Inspection: August 7,2002
D. System Failure Criteria applicable to all systems:
You must indicate"yes"or"no"to each of the following for all inspections:
Yes No
Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool
Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or
clogged SAS or cesspool
Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or
cesspool
Llj Liquid depth in cesspool is less than 6"below invert or available volume is less than day flow
Required pumping more than 4 times in the last year NQT due to clogged or obstructed pipe(s).Number,
of times pumped
-1z Any portion of the SAS,cesspool or privy is below high ground water elevation.
Any portion of cesspool or privy is,within 100 feet of a surface water supply or tributary to a surface
water supply. ,.
AM Any portion of a cesspool or privy is within a Zone 1 of a public well.
,&.14 Any portion of a cesspool or privy is within 50 feet of a private water supply well.
rt,,g Any portion of a cesspool or privy is less than 100 feet but greater than 50 feet from a private water
supply well with no acceptable water quality analysis. !This system passes if the well water analysis,
performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds
indicates that the well is free from pollution from that facility and the presence of ammonia
nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria
are triggered. A copy of the analysis must be attached to this form.)
Nu (Yes/No)The system fails.I have determined that one or more of the above failure criteria exist as
described in 310 CMR 15.303, therefore the system fails. The system owner should contact the Board of
Health to determine what will be necessary to correct the failure.
E. Large Systems:
To be considered a large system the system must serve a facility with esign flow of 10,000 gpd to 15,000
gpd-
You must indicate either"yes"or"no"to each of the following:
(The following criteria apply to large systems in addition to the cr' ria above)
yes no
the system is within 400 feet of a surface drin-' g water supply
_ the system is within 200 feet of a tribu to a surface drinking water supply
the system is located in a nitroge ensitive area(Interim Wellhead Protection Area—IWPA)or a mapped
Zone 11 of a public water sup p well
If you have answered"yes"to any uestion in Section E the system is considered a significant threat,or answered
"yes"in Section D above the 1 e system hat failed.The owner or operator of any large system considered a
significant threat under Sect'_n E or failed under Section D shall upgrade the system in accordance with 310 CMR
15.304.The system own should contact the appropriate regional office of the Department.
4
Page 5 of I 1
OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART B
CHECKLIST
Property Address:
49 Jones Road
Owner:: Marstons Mills,MA
Date of inspection: Jeanie Rooney
August 7,2002
Check if the following have been done. You must indicate"yes"'or"no"as to each of the following:
Yes No
information was provided by the owner. occupant, or Board off lcaltl,
Were any of the system components pumped out in the previous two weeks
Has the system received normal flows in the previous two week period?
Have large volumes of water been introduced to the system recently or as part of this inspection?
_ Were as built plans of the system obtained and examined?(If they were not available note as N/A)
Was the facility or dwelling inspected for signs of sewage back up?
_ Was the site inspected for signs of break out?
Were all system components,excluding the SAS, located on site
Were the septic tank manholes uncovered, opened,and the interior of the tank inspected for the condition
of the baffles or tees,material of construction,dimensions,depth of liquid, depth of sludge and depth of scum?
Was the facility owner(and occupants if different from owner)provided with information on the proper
maintenance of subsurface sewage disposal systems
The size and location of the Soil Absorption System(SAS)on.the site has been determined based on:
Yes no
Existing information. For example,a plan at the Board of Health.
✓ _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance
is unacceptable)[310 CMR 15.302(3)(b)j
5
Page 6 of I
OFFICIAL INSPECTION.FORM-NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION
Property Address:
49 Jones Road
Owner: Marstons Mills,MA
Date of inspection: Jeanie Rooney
August 7,2002FLOW CONDITIONS
RESIDENTIAL
Number of bedrooms(design): 3 Number of bedrooms(actual): 3
DESIGN flow based on 310 CMR 15.203(for example: 110 gpd x#of bedrooms): 3 30
Number of current residents: 3 T
Does residence have a garbage grinder(yes or no):A/o
Is laundn on a separate sewage system(yes or no):No [if yes separate inspection required]
Laundry system inspected(yes or no):
Seasonal use:(yes or no):_o
Water meter readings, if available(last 2 yearsltsage(gpd)):
Sump pump(yes or no): ivv
Last date of occupancy:
COMMERCIAL/INDUSTRIAL
Type of establishment:
Design flow(based on 310 CMR 15.203): gpd
Basis of design flow(seats/persons/sgft,etc.):
Grease trap present(yes or no):—
Industrial waste holding tank present(yes or no):
Non-sanitary waste discharged to the Title 5 syste yes or no):_
Water meter readings, if available:
Last date of occupancy/use:
OTHER(describe):
GENERAL INFORMATION
Pumping Records
Source of information: ,,t 8/21 /9,> . r
Was system pumped as pan of the inspection(yes or no wo
If yes, volume pumped: gallons-- How was quantity pumped determined?
Reason for pumping:
TYPE OF SYSTEM
Septic tank,distribution box,soil absorption system
_Single cesspool
_Overflow cesspool
_Privy
_Shared system(yes or no)(if yes,attach previous inspection records,if any)
_Innovative/Alternative technology.Attach a copy of the current operation and maintenance contract(to be
obtained from system owner)
Tight tank _Attach a copy of the DEP approval
Other(describe):.
proximate age of all components. date installed(if known)and source of information:
C& J 546-1fi'A
ere sewage;odors detected when arriving at the site(yes or no): ,tvi
f
6
Page 7 of l l
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
49 Jones Road
Owner: Marstons Mills,MA
Date of Inspection: Jeanie Rooney
August 7,2002
BUILDING SEWER(locate on site plan)
Depth belo%% grade: I ' 4-
Materials of construction: _cast iron Z40 PVC_other(explain):
Dktaricr fron-,private water supply well or suction line: „ 1A
Comments(oncondition of joints,,venting,evidence ol.leakage,etc.):
Ef'v1�.c/� (• w� 6 u.a✓1 7c- C�cu r.
SEPTIC TANK: ✓(locate on site plan)
Depth below grade: 3''
Material of construction:lzconcrete_metal_fiberglass_polyethylene
—other(explain)
If tank is metal list age: _ Is age confirmed by a Certificate of Compliance(yes or no)''_(anach a copy of
certificate)
Dimensions: S'k 9 ')e i, /000
Sludge depth:
Distance from top of sludge to bottom of outlet tee or baffle: .Z
Scum thickness: tea,.,/-
Distance from top of scum to top of outlet tee or baffle: iyo s
Distance from bottom of scum to bottom of outlet tee or baffle: N� S
How were dimensions determined: saw b<
Comments(on pumping recommendations, inlet and outlet tee or baffle condition, structural integrity, liquid levels
as related to outlet invert,evidence of leakage,etc.): /.
GO•.4✓L.�-.t �tc.J" yJtv.� TTj�ti� h __E— �rr�• hr �Y._ I��ia �✓_(�cr. `t_�_�
A-
GREASE TRAP:_(locate on site plan)
Depth below grade:
Material of construction:_concrete_metal_fiberglass/yyethylene_other
(explain):
Dimensions:
Scum thickness:
Distance from top of scum to top of /age,
l .
Distance from bottom of scum to bo or baffle:
Date of last pumping:
Comments(on pumping recommend outlet tee or baffle condition,structural integrity,liquid levels
as related to outlet invert,evidence o
7
• Page 8 of 11
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
49 Jones Road
Owner: Marstons Mills,MA
Date of Inspection: Jeanie Rooney
August 7,2002
TIGHT or HOLDING TANK: (tank must be pump/fimnepection)(locate on site plan)
Depth below grade:
Material of construction: concrete metal fibyethylene other(explain):
Dimensions:
Capacity: gallons
Design Floe: gallons/day
Alarm present(yes or no):
Alarm level: Alarm in working or r(yes or no):
Date of last pumping:
Comments(condition of alarm an) t switches,etc.):
DISTRIBUTION BOX: v/(if present must be opened)(locate on site plan)
Depth of liquid level above outlet invert:
Comments(note if box is level and distribution to outlets equal,any evidence of solids carryover, any evidence of
leakage into or out of box,etc.):
n- �?o ,,,.j•.. , -,��,, a L i J s r .,...l c.% c. ✓ '/�, r y c. d -� c:u �'
-16ZfL4--t4--`. r+
PUMP CHAMBER: (locate on site plan)
Pumps in working order(yes or no):
Alarms in working order(yes or no):
Comments(note condition of pump chamber,conditio /pumps ppurtenances,etc.):
8
Page 9 of l l
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address:
49 Jones Road
Owner: Marstons Mills,MA
Date of Inspection: Jeanie Rooney
August 7,2002
SOIL ABSORPTION SYSTEM(SAS):Z(locate on site plan,excavation not required)
If SAS not located explain why..
Type
leaching pits, number:_
leaching chambers,number: 2- Soo Y` /J' Cc,�.,.6 , ,,.,`� it,
leaching galleries,number:
leaching trenches,number, length:
leaching fields,number,dimensions:
overflow cesspool,number:
innovative/altemative system Type/name of technology:
Comments(note condition of soil,signs of hydraulic failure, level of ponding,damp soil,condition of vegetation,
etc.):
j
1.1'-) S kZ c .� fnJ r.. - Y✓ ( w.a t To v�. e /�t..i i ti ci
-hi s 12- c✓:�c f 14 Jt r ✓ 1'
S
CESSPOOLS: (cesspool must be pumped as part of inspection)(loc a on site plan)
Number and configuration:
Depth—top of liquid to inlet invert:
Depth of solids layer:
Depth of scum la\er. _
Dimensions of cesspool:
Materials of construction: _
Indication of groundwater inflow(yes or nXhyulic
Comments(note condition of soil,signs of failure, level of ponding,condition of vegetation,etc.):
PRIVY: (locate on site plan)
Materials of construction:
Dimensions:
Depth of solids:
Comments(dote condition of soil,signs of by lic failure,level of ponding,condition of vegetation,etc.):
9
• Page 10 of 1 l
OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION(continued)
Property Address: 49 Jones Road
Marstons Mills;MA
Owner: Jeanie Rooney
Date of Inspection: August 7,2002
SKETCH OF SEWAGE DISPOSAL SYSTEM
Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or
benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the buildino.
w�i�
you} '
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Page l l of l l
OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASSESSMENTS
SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM
PART C
SYSTEM INFORMATION (continued)
Property Address:
49 Jones Road
Owner: Marstons Mills,MA
Date of Inspection: Jeanie Rooney
August 7,2002
SITE EXAM
Slope
Surface water
Check cellar ✓
Shallow wells
Estimated depth to ground water -, 0 a feet Adjusted high ground water elevation — feet
Please indicate(check)all methods used to determine the high ground%%ater elevation:
Obtained from system design plans on record- if checked,date of design plan reviewed:
Observed site(abutting property/observation hole within 150 feet of SAS)
Checked with local Board of Health-explain:_�j_, - �-
Checked with local excavators, installers-(attach documentation)
Accessed USGS database-explain: S,, _�,t
M
You must describe how you established the high ground water elevation:
CAS G S wuj,✓ —
-
rt 1040 , o I-a J.;,:.L- Y 3, 0 n
•.�•� err-/-<--�_/ ._ ,- ��� � / �....
7.
a ".-1 ✓�. /...3 c.a _ v._.S. v c� 4-
II
No. —� Fee $ 5 0.0 0
. THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Yysl
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLEs MASSACHUSETTS
Rppl cation for �Dis;pogaf bp!gtem tonotruction Vermit
Application for a Permit to Construct( )Repair(X X)Upgrade( )Abandon( . ) O Complete System -0Individual Components
Location Address or Lot No. 4 9 Jones Road Owner's Name,Address and Tel.No. 4 2 8—5 5 0 6
Marstons MI11s,Mass . 02648 C. Marchetti
Assessor'sMap/Parcel 036 49 Jones Road Marstons Mills,Mass.
Installer's Name,Address,and Tel.No. 5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No.
J.P.Macomber & Son Inc. J.P.Macomber & Son Inc .
Box 66 Centerville ,Mass. 02632 Box 66 Centerville ,Mass. 02632
Type of Building: XX
Dwelling X No.of Bedrooms 3 Lot Size sq. ft. Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Adding two 5 0 0 g a 1 1 n n chambers
packed in 41 of 11 stone. There is an existinp, 1006 gallon
septic tank and a 1000 gallon precast leaching t .
Date last inspected: a/,a.C(,� g4lG C(
Agreement: r .QG-P r�IG�r�• Z'� ""7'/ �� �j'
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system ✓/P
in accordance with the provisions of Title 5 of the Environmental Code an not to place the system in operation until a Certifi-
cate of Compliance has been issu 91by s o o th.
Signed a Date 8125/99
Application Approved by Date r1Z d
Application Disapproved for the following reasons
Permit No. — Date Issued
---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
Certificate of Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )RepairedXX )Upgraded( )
Abandoned( )by J.P.Macomber & Son Inc,
at 4 9 Jones R o 8•d Marstons Mi 11 s Mass. has een constructe acc in rdance
with the provisions of Title S and the for Disposal System Construction Permit No. — � dated 2
.Intaller J.P.Macomber & Son Inc. Designer J.P.Macomber & Son Inc.
The issuance of sperm Vtsall be ed as a arantee that the s function as n
Date =t ' 7 % Inspecto
-----------------
i
water Report# 820071
•
Date Collected: 7/28/00
red"t Date Received: 8/ 2/00
Lab Certification No. 11676 DOH NY _Page 1 of 1 Date Analyzed: 8/2/00
Customer:Tiger Home Inspection Client : Jeanie Rooney
969 Washington Street Sample
Braintree, MA 02184- Location: 49 Jones Rd.
Marstons Mills, MA
Matrix: Drinking Water
Sample This sample taken by K. Dumas at 04:00 PM on 7/28/00.
Purchase Order#: Description Point of Collection: Kitchen.
* Standard Scan Report
Parameters tested meets EPA Primary(health related limits for drinking water
RESULTS DESCRIPTION
WHO
Total Coliform Absent Present Animal/Vegetational Bacteria (Health Related) 01100
Fecal/E.Coli Absent Present Animal Bacteria (Health Related) 01100
Sodium 11.3 250.0 mg/L 20.0 mg/I is Mass. DEP Guideline 0.05
Potassium 3.0 No Limit(mg/L) A Component of Salt (Aessthetic) 0.02
Copper 0.39 1.30 mg/L Indicates Plumbing Corrosion (Aesthetic) 0.006
Iron 0.12 0.30 mg/L Brown Stains, Bitter Taste (Aesthetic) 0.003
Manganese 0.02 0.05 mg/L May Cause Laundry Stainin (Aesthetic) 0.001
Magnesium 3.1 No Limit(mg/L) A Component of Hardness 0.005
Calcium 2.5 No Limit(mg/L) A Component of Hardness 0.008
Arsenic Not Detected 0.05 mg/L A Toxic Metal (Health Related) 0.006
Lead Not Detected 0.015 mg/L A Toxic Metal (Health Related) 0.005
pH * 6.09 6.5-8.5 SU Acidic/Basic Determination (Aesthetic) 0-14
Turbidity 0.90 No Limit(N.T.U. Presence of Particles 0.10
Color 1.0 15.0 C.U. Clarity(0) Discoloration(15) (Aesthetic) 1.0
Odor Not Detected 3.0 T.O.N. Odor due to Contamination (Aesthetic) 0.50
Conductivity 139.0 700 umhos Electrical Resistance(umhos/cm) 0.10
T.D.S. 83.4 500 mg/L Total Dissolved Minerals Present (Aesthetic) 1.0
Sediment Absent Present Undissolved Solid Pres/Abs
Alkalinity 10.0 No Limit(mg/L) Ability to Neutralize Acid (Aesthetic) 1.0
Chlorine Not Detected No Limit(mg/L) A Disinfectant 0.01
Chloride 9.6 250 mg/L A Component of Salt (Aesthetic) 1.0
Hardness 19.0 No Limit(mg/L) 0-75 is Considered Soft 1.0
Nitrate 3.4 10.0 mg/L Indicator of Biological Waste (Health Related) 0.10
Nitrite Not Detected 1.0 mg/L Indicator of Waste (Health Related) 0.01
Ammonia Not Detected No Limit(mg/L) Indicator of Waste 0.01
Sulfate 4.5 250 mg/L A Mineral,Can Cause Odor 1.0
*= Outside of Recommended Limits
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INSTALLER'S NAME&PHONE NO. / . �a�j k44-
SEPTIC TANK CAPACITY
LEACHING FACILITY: (type)'�� n (size)
NO.OF BEDROOMS ✓�
—B,UV�OR OWNER t I✓1 �` •���T't
PERMITDATE: ?- 2 1-, %��COMPLIANCE DATE: "'� �
Separation Distance Between the:
Maximum Adjusted Groundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on site or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility(If any wetlands exist
within 300 feet of leachiny,facility) Feet
Furnished by 1,, % /;',
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I,1 147 �1 ✓ a` 4
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No. ! —s t Fee 0 O O
THE COMMONWEALTH OF MASSACHUSETTS Entered in computer:
Y
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLES MASSACHUSETTS
ZIPPIftation for Migonl 6pgtem Conetruction Vermtt
Application for a Permit to Construct( )Repair(X X)Upgrade( )Abandon(,. ) ❑Complete System -Q Individual Components
Location Address or Lot No. 4 9 J o n e s R o a d Owner's Name,Address and Tel.No. 4 2 8—5 5 0 6
Marstons MI11s ,Mass . 02648 C. Marchetti
Assessor's Map/Parcel 0 �/&/ O,T6 49 Jones Road M a r s t o n s Mills ,Mass .
Installer's Name,Address,and Tel.No. 5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel.No. 8
J.P.Macomber & Son Inc. J.P.Macomber & Son Inc .
Box 66 Centerville,Mass. 02632 Box 66 Centerville,Mass . 02632
Type of Building: X X
Dwelling X No.of Bedrooms 3 Lot Size sq.ft. Garbage Grinder( )
Other Type of Building No. of Persons Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallons per day. Calculated daily flow gallons.
Plan Date Number of sheets Revision Date
Title
Size of Septic Tank Type of S.A.S.
Description of Soil
Nature of Repairs or Alterations(Answer when applicable) Adding two 500 gallon r h a m b e r s
packed in 4 ' of 12" stone , There is an existing1000 allo
ri
septic tank and a 1000 gallon precast leachin t . LL 10
/
Date last inspected: /�/� n! a4_ (L 4l(�
Agreement: " `� Y t '�G�r(�s`�°p�j C/ /
The undersigned agrees to ensure the construction and maintenance of the afore described on-site sewage disposal system ��
in accordance with the provisions of Title 5 of the Environmental Code an not to place the system in operation until a Certifi-
cate of Compliance has been issue by this o o lth.
Signed Date 8 2 5 9 9
Application Approved by % Date Z 6 I
Application Disapproved for the following reasons
Permit No. — Date Issued
* No. ( ( —- / C Fee $ 5 0. 0 0
THE COMMONWEALTH OF MASSACHUSETTS ""'^ Entered in computer:
PUBLIC HEALTH DIVISION -TOWN OF BARNSTABLE, MAStACHUSETTS
ZIpprication for ;Di000l *pgtem Congtructia'p Verntit VS
Application for a Permit to Construct( )Repair(XX)Upgrad ( �)Abandon( ) [I Complete Syste Individual Components
Location Address or Lot No.4 9 J o n e s R o a d Owner's Name,Address and Tel.No. Q2 8—5 5 0 6
Marston`, MIlls,Ma}ss. 02648 C. Marchetti '
Assessor'sMa0arcel n `_t9l 0 "D 49 Jones Road Maestofts Mills,Mass.
Installer's Name,Address,and Tel.No. 5 0 8—7 7 5—3 3 3 8 Designer's Name,Address and Tel. .
J.P.Macomber & -Son Inc. J.P.Macomber &, oil Inc.
Box 66 Centerville,Mass. 02632 Box 66 Cet'ervil ,Mass . 02632
Type of Building: X X '
Dwelling X No.of Bedrooms 3 Loo sq. k` Garbage Grinder( )
Other Type of Building .R-No. of Persons `. Showers( ) Cafeteria( )
Other Fixtures
Design Flow gallon per day. Calculated datiy flow t gallons.
Plan Date Number of Beets ice'` i' Revision�`�Date\
Title �`
�-',4 ✓ .,/
Size of Septic Tank L t Type of S.A. o
l-i
Description of Soil - 4
Nature ofg a of Alterations(Answer when applicable) Adding two 500 gallon chamber s
packed ;; ► of l� stone. There is an existi'mg 1000 gallon
0
ic :Otanr, and a 1U00 g ,1_]_Om—p-r a c--&S t-I—eZt p i n g pit .
`e /
Date last inspected: " r e-C 6L
Agreement: AAA Y t G 5(A", +
The undersigned agrees to—ensure the constwtcW �.ma ntenan e a the of ye E Bed opts e-sewage-disposal system��
in accordance with the provisions of Title 5 of the Envirdn e 1 Code and not to place s) eminoperation until a Certifi-
cate of Compliance has been issuedby oWr—prIth—
�this
Signed Date 8/2 5/9 9
Application Approved by _ Date rlrgz2a
Application Disapproved for the following reasons
Permit No 5— Date Issued
---------------------------------------
THE COMMONWEALTH OF MASSACHUSETTS
BARNSTABLE, MASSACHUSETTS
(Certificate of (Compliance
THIS IS TO CERTIFY,that the On-site Sewage Disposal System Constructed( )Repaired 4 X )Upgraded( )
Abandoned( )by J.P.Macomber & Son Inc .
at 49 Jones R o a-d Ma r s t o n s Mills ,Mass. has peen constructed in accordance
with the provisions of Title 5 and the for Disposal System Construction Permit No. 99—T-qY dated 2
Installer J.P.Macomber & Son Inc. Designer J.P.Macomber & Son Inc.
The issuance of s permit shall n�,t bef�n§oued as a guarantee that the s e w'11 function as de �!e '
W-"4
Date �3 ° % Inspector
/ --------------------------- --
No. Fee $ 5
THE COMMONWEALTH OF MASSACHUSETTS
PUBLIC HEALTH DIVISION - BARNSTABLE,. MASSACHUSETTS
Dioo.5ar *pgtem Con5truction Permit
Permission is hereby granted to Construct( )Repair(X X)Upgrade( )Abandon( )
Systemlocatedat 49 Jones Road Marstons Mills,Mass.
and as described in the above Application for Disposal System Construction Permit. The applicant recognizes his/her duty to
comply with Title 5 and the following local provisions or special conditions.
Provided:Construction must be mpleted within three years of the date of this permit.PP
i
Date: Z� Approved by. /--�.
f
116199
NOTICE: This Form Is To Be Used For the Repair Of Failed
Septic Systems Only.
CERTIFICATION OF SKETCH AND APPLICATION FOR A DISPOSAL
WORKS CONSTRUCTION PERMIT (WITHOUT DESIGNED PLANS)
I, Joseph P Ma c o m b e r J r , hereby certify that the application for disposal works
construction permit signed by me dated 8/2 5/9 9 concerning the
property located at 49 Jones Road Marstons Mills Mass . meets all of the
following criteria:
• The failed system is connected to a residential dwelling only. There are no commercial or business
uses associated with the dwelling.
• The soil is classified as CLASS I and the percolation rate is less than or equal to 5 minutes per inch.
• There are no wetlands within 100 feet of the proposed septic system
• There are no private wells within 150 feet of the proposed septic system
• There is no increase in flow and/or change in use proposed
• There are no variances requested or needed.
The bottom of the proposed leaching facility will not be located less than five feet above the
maximum adjusted groundwater table elevation. (Adjust the groundwater table using the Frimptor
method when applicable]
• If the S.A.S. will be located with 250 feet of any vegetated wetlands, the bottom of the proposed
leaching facility will not be located less than fourteen(14) feet above the macimum adjusted
groundwater table elevation,
Please complete the following:
A) Top of Ground Surface Elevation(using GIS information) 9 9$
B) G.W. Elevation I +the MAX. High G.W. Adjustment.
DIFFERENCE BETWEEN A and B �J
SIGNE G DATE: 8/2 5/9 9
(Sket roposed plan of system on back].
q:health folder.ccn
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_ TOWN OF BARNSTABLE
LOCATION CS SEWAGE # -
VILLAGE n ASSESSOR'S MAP & LOT-0bP��30
INSTALLER'S NAME&PHONE NO. lf->0I �GL'1L
SEPTIC TANK CAPACITY I�W>17
o/
LEACHING FACMITY: (type)`? l i �/✓gy m (size) �d
NO. OF BEDROOMS ✓ Ole
—B OR OWNER
PERMITDATE: t" COMPLIANCE DATE:
Separation Distance Between the:
Maximum Adjusted-Jroundwater Table to the Bottom of Leaching Facility Feet
Private Water Supply Well and Leaching Facility (If any wells exist
on siW or within 200 feet of leaching facility) Feet
Edge of Wetland and Leaching Facility (If any wetlands exist
within 300 feet of leaching facility) Feet
Furnished by
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No........:(�'-.5...... Faa.....��. ...
THE COMMONWEALTH OF MASSACHUSETTS
BOARD F H EAf KT ,
-r . ... oF....... . :........... ..: ...... ..------------.
Appliration -for 43itipuittl Workii Tomitrnrtion Vrrrnit
Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
7
'Ail r
........17.011.0 '-' --------------------------------------------------------------- ................................... -1-4...................................................
Location-Address or Lot N .
49.� v----x rl]'1U.A Q........e n-Jol----_----------------- .....11°...iS 7-•----1%1`/N Al Air ...-----------------------
a Owner Address
f`D..--•---------..---------------------------•••-••---------•--•--....... ...._.........................5-k 5.k!hl......................................................
Installer Address
d Type of Building P t.r•I)•X Size Lot----------------------------Sq. fe t
U Dwelling—No. of Bedrooms-----I------------------------------------Expansion Attic ( ) Garbage Grinder
aOther—Type of Building ............................ No. of persons.--_-_------_----_--.__.--_- Showers ( ) — Cafeteria )
a' Other fixtures ......................................................
--------------------------------------- ..............................
Design Flow_______________` �--_-.____--_--_-_.--gallons per person per day. Total daily flow_____-__�-f_�_-_____-_-__-------.....gallons.
WSeptic Tank 1 Liquid capacity.10.9b-gallons Length--__-I......... Width----- -°_ ` _'_.. Diameter Depth. _......._.
x Disposal Trench—No..................... Width..........._,�.O�Total Length-------------------- Total leaching area--------------------sq. ft.
Seepage Pit No...._-9_____________ Diameter -----
Depth below inlet-___4_�_�__-____ Total leaching area...t o v_6__--sq. ft.
z Other Distribution box ( ) Dosing tank ( ) O j6- /OC/;%.t - -2 -/✓-`7 7
aPercolation Test Results Performed bY........... --------------------------•---------------------------•------- Date---------------•------------------------
,� Test Pit No. 1................minutes per inch Depth of Test Pit-------------------- Depth to ground water-_--------------------
4q Test Pit No. 2................minutes per inch Depth of Test Pit-------------------- Depth to ground water---------------._---___.
0 ------. r1,�p K---- 1 ,;- v ------T-L---- -
Description of Soil--...".._._. .. "-- _ �' t✓-___ _ _-.
x G - =,:-
w
UNature of Repairs or Alterations—Answer when applicable.-.-_................................................:..........................................
------------------------------ -------------------------------------------------•----------•--------------------------------------------------------•------------------------------------------------...
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI,of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
ed
Fe � --------------------
_ Date
Application Approved BY /_...... _1_ _7..__Date
Application Disapproved for the following reasons:----•------------------•------------•-------------------------------------•-•-•---------------------------------
---------------------------••----------------------------------............------•-••------•-------------•----...---------------•------------------------.........-------------------------------------
Date
PermitNo......................................................... Issued...................... .................................
Date
i
No..-/--4' S Fs�.......... ................
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEA TH
.........OF........�0
Applira#roar -fur D q o-qat lVarkii Totts#raar#tntt Vrrt ai#
Application is hereby'made for a Permit to Construct ( ) or Repair ( ) an Individual Sewage Disposal
System at:
�J t1 3f-r S 81.AJ---------------------------------•-----_......................
Location.Address or Lot No.
-•��•i•.`•{------------------------Pt,1' t � -----•------<�2-`. ......................•. ....h?---is..... ...................................
owner J Address
Installer Address
UType of Building Size Lot----------------------------
Sq.pft
Dwelling—No. of Bedrooms._--_3_...--_----_.._.•_________________Expansion Attic ( ) Garbage Grindery
Other—Type of Building ----------.--_------------- No. of pel sons.._________._____---_ Showers )
a g _ l -: ...._. ( ) — Cafeteria
Otherfixtures ------------------------------------------------•------•- _---------------------------•--•...........••••.....--••--. ----
W Design Flow...............`3-_49--------------------gallons per person per day. Total daily flow........�J. -----------------------gallons.
W !Septic Tank Liquid capacity_l_���_gallons Length____!,.._`._... Width-----fit__'.._.- Diameter
------ --------- Depth._5'.`........
x Disposal Trench—No--------------------- Width-_-------.--_ - - Total Length-------------------- Total leaching area--------------.-----sq. ft.
Seepage Pit No-------l------------- Diameter_l�'�aUC.....`�l�epth below inlet----- ------- Total leaching area.... it.
z Other Distribution box ( ) Dosing tank ( ) 01 /9C 17-� • �2 - /j . 7'
aPercolation Test Results Performed bY-------------------------------------------------------------------------- Date----------------------------------------
Test Pit No. 1----------------minutes per inch Depth of "lest Pit-------------------- Depth to ground water...-----_--__---_.-__...
f� Test Pit No. 2................minutes per inch Depth of Test Pit-----------......... Depth to ground water__._-__--_--_-___----. -
::�` r I.r....--- . -•----•--.-• •----------------••-----
_ k �� Z
Description of Soil---- L c 7__ ......
/ '
J= ... l-- �_`-vim .. :_...
x C F
U �1 =�"' ------NCJ��.f�......T----:' --------------------
W
UNature of Repairs or Alterations—Answer when applicable................................................................................................
--------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------- ----------------------------
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions of Article XI of the State Sanitary Code—The undersigned further agrees not to place the system in
operation until a Certificate of Compliance has been issued by the board of health.
✓g>ned �' �
,. Date
Application Approved BY---------------- ---J-j--------�--d-."-t---��-��t--- -- - " ---;�__<J_-_..7...--�----------
` Date
Application Disapproved for the following reasons------------------------------------------------------------------------•---------------------------------------
---------------------------------------------------------------------------------------------•---------------------------------------------------------------------------------------------------------
Date
PermitNo......................................................... Issued........................................................
Date
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OFF HEALTH
......... .. ..............O F..............: ✓...r�''1-' :- .....................................
T419- IS TO CE TI Y, That the Individual Sewage Disposal System constructed ( or Repaired ( )
by f =.lam.._...
/ 1 I st ller -f,
has been installed in accordan e with the provisions of : �4i�le!XI of The State Santtary Code as described in the
r ��y. -•••-••-•-_.... dated for Disposal Works Construction Permit Now%_ .___.__� s ?.'./�_.._..7_,7..............
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY. �
DATE ... Inspector - --- ----------------
THE COMMONWEALTH OF MASSACHUSETTS
BOARD (?f HEALTH
JS' .........../...... .........OF.......142:'c'L"�r........... ..........•--•------•----...............
No......................... FEE..................�
Permission is hereby granted--- -`yL ;C-.G'..G
to Constct or Repait� ( ) andiv�idual r �nlage D�osal Systei!n
�r ( -
�. /
�,•-•.-�--.---•-•---:-- Street
as shown on the application for Disposal Works Construction Permit N ..___. -_ _... Dated__-.,5-�/ ---7 7
----------------••-----•-•-----_
----.•--•--•-----------------------------•----••..................------•.... Board of Health/
DATE_ �
FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS
`O.,CATION _ < SEWAGE PERMIT NO.
)-o�' y 3 1� o.r/�.� 9�J 47
- VILLAGE l
M . P1, L
1NSTA LLER'S NAME & ADDRESS
��. Jo 1-4
B UIlDE R OR OWNER
DATE PERMIT ISSUED f 7
DATE COMPLIANCE ISSUED /Y��
1
1.
Act4S
LO,C AT ION `T SEWAGE PERMIT NO.
VILLAGE
p l i k 4
INSTA LLER'S NAME & ADDRESS
�UijZ/-L Jr/ 14Al
C U I'L D E R OR OWNER
DATE PERMIT ISSUED I ZZ 7
DATE COMPLIANCE ISSUED
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